Homework help, week 12

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Timmons_PICOT.docx

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PICOT Question

Olivia Timmons

St. John’s River State College

App Evidence-Based Practice in Nursing

Professor Graham

June 6th, 2021

PICOT Question

The emergency department (ED) crowding has become a major concern in the entire world as it affects the delivery of quality healthcare services to patients. The emergency department is faced with the challenges such as the increase in patient visits, overcrowding, and the prolonged length of hospital stay. The cause of these problems is considered to be multifactorial. The ED crowding leads to the delay in the management of the patients thus affecting their overall healthcare quality. It leads to the delay in time to antibiotics administration for the patients suffering from pneumonia, and the increase in the adverse outcomes of cardiovascular for a patient suffering from chest pain. Such delays further increase the reported cases of morbidity and mortality among emergency clients. Therefore, one of the effective interventions that can be used to solve this issue targets the reduction in the emergency length of stay (LOS). The shorter the length of stay in the emergency department, the higher the level of satisfaction by the patients and lower the reported cases of morbidity and mortality (Chaisirin, et al., 2020).

The laboratory turnaround time (TAT) is considered to be the time at which the blood sample is being accessed or taken to the time at which the results from the laboratory tests are reported. The prolonged TAT leads to the delay in the treatment process and causing an increase in the length of stay in the emergency department thereby resulting in the crowding of the emergency department. The delays in the laboratory are often perceived to be the contributory factors to the delays in the delivery of healthcare services and increase in the length of hospital stay. According to Vilaine et al (2020), the point of care testing (POCT) that is performed at the bedside leads to the shortening of the turnaround time and the length of stay. The turnaround time and the point of care testing are always shorter than that of the central laboratory tests. The point of care is leading to the reduction in the mean and the median of the length of stay (Villaine, et al., 2020).

Most of the hospitals are facing the problem of having a steady increase in patient visits and the ability constraints that leads to overcrowding, delay in the provision of healthcare services, and the prolonged length of stay. Several factors are linked to this problem and this includes the shortages in the emergency departmental staff for example nurses and physicians; the limited number of emergency departmental beds; the existence of obsolete physical facilities; lack of adequate knowledge o the process flow and operations within the emergency department; and the delays within the radiology and the laboratory services. Other factors linked to the problem include inadequate outpatient treatment facilities to accept the emergency transfers for example to the mental health facilities; the reduction or the inadequate number of primary care physicians to ensure that there is successful treatment of the acute issues within the outpatient departments; and the increase in the number of the patient population who are not insured as well as the patients who are considered to be indigent (Patel & Suh-Lailam, 2019).

Foreground

Picot Question: Is there a significant decrease in Emergency Department patient length of stay (LOS) for those whose blood was analysed using POC testing versus those whose blood was analysed using laboratory testing?

Population: the emergency room patients. The population, in this case, is the patients who require emergency services. These patients are exposed to the risks of complications as a result of the delay in the treatment process. They are highly exposed to cardiovascular complications especially for the patients suffering from pneumonia and requires emergency services. These patients also experience delays in radiology, the laboratory, and the delay in the inpatient needs.

Intervention: the POC testing of blood specimens. The intervention, in this case, involves the use of the POC to help in the analysis of the blood. The point of care is perceived to be important in the improvement of the emergency department by accelerating the particular types of clients.

Comparison: laboratory blood specimen. The intervention is compared to the use of the laboratory to analyse the blood of the patients. The delays in the laboratory are often perceived as the contributory factors to the delay in the healthcare service delivery and increase in the length of hospital stay.

Outcome: The reduction in the patient stay in the emergency room. the effective intervention is aimed at addressing the issues that are faced at the emergency department. Therefore, the expected outcome upon the implementation of the intervention is the reduction in the length of stay in the emergency department, improvement in the operations within the emergency department, reduction I the wait time in the patient queues in the patient flow, reduction in the morbidity, reduction in the mortality, and improvement in the patient satisfaction.

References

Chaisirin, W., Wongkragjang, P., Thoesam, T., Praphruetki, N., Nakornchai, T., Riyapan, S., . . . Chakorn, T. (2020). Role of Point-of-Care Testing in Reducing Time to Treatment Decision-Making in Urgency Patients: A Randomized Controlled Tria. West J Emerg Med, 21(2), 404-410. doi:10.5811/westjem.2019.10.43655 Patel, K., & Suh-Lailam, B. B. (2019). Implementation of point-of-care testing in a pediatric healthcare setting. Critical reviews in clinical laboratory sciences, 56(4), 239-246. https://doi.org/10.1080/10408363.2019.1590306 Villaine, E., Gabarre, P., Beauchet, A., Seidowsky, A., Moreau, M., Massy, Z., & Auzel, O. (2020). Point-of-Care Capillary Blood Creatinine: A Prospective Study In Cardiology and Nephrology Outpatients. https://doi.org/10.21203/rs.3.rs-120701/v1